(work out, complete chores, finish tasks, etc.), and increased agitation and anger over inconsequential
things. During mania, I am hyperaware of my surroundings and tend to overanalyze others’ words
and tone, and I get very frustrated with others who impede my desire to get things done. As the
mania progresses, I become a flight risk. I’ve left my home, moving cars, hospitals, psychiatric
facilities, and social gatherings. At times, I’ve shed clothing (sometimes, all of it). During my last
major break, I was in Las Vegas to celebrate my manager’s birthday. His celebration was on Saturday
afternoon. I barely slept Thursday and Friday. By Saturday morning (predawn), I had left my hotel
room, wandered through casinos until sunrise, purchased a bus ticket, rode to the airport, flew to
Denver, lost my wallet, flew to DCA, then walked thirteen miles overnight toward home until an
ambulance transported me to a hospital. Hopefully, that is my last break.”
The disease takes its name from the fact that it presents as both mania and depression. So, after
listening to this vivid description of mania, I ask Jeff about the other half: depression. “It gets
centered on the shame and guilt of the destruction I’ve wrought with the mania. The loss of trust,
shattered relationships, having to start from zero. Sometimes I’m an impatient individual yet wanting
what I want on my terms. This disease is treatable, but you have to follow the path. At the crux is
always I was not taking my medication as prescribed, because I thought I could handle it. That’s the
insidiousness of this disease. You go, Oh, you’re still fine, you don’t need those meds. That thought
erodes the pharmaceutical foundation of keeping me in the sane box instead of the manic box. I can’t
control bipolar, so I have to take a drug, but I don’t want the drug because some of those early manic
symptoms feel good, such as increased productivity and energy. Bipolar says, You don’t need the
drug; then, bipolar takes me. Part of the depression results from knowing I can’t control this. But
most of it comes from the pain I’ve caused others.”
He manages his relationships as best he can. “Bipolar makes others question me. Is that just Jeff
being excited, or is he off his medication? I feel that extra critical lens applied to me around what I
do, how I act, and how I speak. After an episode, this feeling of a critical lens on me happens for the
next six months or so. Then, once I establish a new pattern, those concerns from others get less and
less. It’s my own fault. I eroded the trust that my wife and children placed on me to take my meds
every day. We’re going through counseling to make sure we do what we need to do to work on our
relationship.”
This is all really a lot. Jeff’s situation—the very narrow ledge he must walk through life, never
deviating from his meds ever, and the serious consequences that come if he steps off that ledge—
seems a very challenging adult life to me. I’ve never been through something like this. I ask Jeff how
he copes. “First, I’m a huge proponent of medication and counseling. Neuropsychiatry, psychology,
and pharmacology have made huge strides over the past three decades in developing treatments for
mental and behavior disorders like depression, anxiety, bipolar, etc. The bad news is that everybody
reacts differently to medications and different counseling methods, so it may take time to find the
right counselor, medication, and dosage. So, step one in recovery and maintenance is find your
counselor, see them regularly, and take your meds as prescribed. Do not self-medicate with alcohol,
cannabis, or other drugs of choice. Communication is key: be open with doctors and other care
networks (counselors, colleagues, friends, family).”
The second thing Jeff does is surrender to the vulnerability. “Everything I’ve gone through
prepared me for the next thing, and the next thing,” Jeff says. “When you’re obsessed with the power
of the individual, then your vulnerability and lack of control seem like weaknesses. But I see strength
in vulnerability. I may not know the whole plan, but in surrendering control to a God that loves us,
there’s a release. Twenty years after my first manic episode, through my church I am now a counselor
for other people who have mood disorders, including bipolar, depression, anxiety, OCD, and other
challenges.” One of his daughters reminds him of his past self—early in high school she was very
invested in following a traditional path to success by taking the “right” classes, going to the “right”